Cats are notoriously enigmatic creatures. Like the Cheshire Cat in Alice in Wonderland , your cat keeps secrets. She may not show pain or other signs that she is sick. That’s why subtle signs of illness in cats require prompt veterinary attention.
Your cat keeps secrets
Cats retain many of their species’ undomesticated behavioral characteristics. In the wild, all but the largest cats are both predator and prey. It’s important for animals that are being hunted as prey to hide their weaknesses. Consequently, cats have become masters of misdirection.
Veterinary professionals struggle to define the signs of pain in cats consistenly. A validated method to score pain, for instance, is useful in assessing recovery from painful procedures or illness. Cats’ tendency to mask their pain and demonstrate only very subtle behavioral changes makes reliable detection and grading of pain difficult at best.
A large survey of feline medical specialists evaluated 91 signs of pain. Participants answered questions about the reliability of these indicators of pain to accurately detect real pain in cats. The participants narrowed these signs down to only 22. You can find the full list in the article, which is available as a free full text in PubMed. 1
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Signs of illness in cats require prompt attention
Because cats hide pain and other evidence of ill health, any unusual signs you observe are probably just the tip of the iceberg. As a cat owner, you should take any and all behavioral changes in your cat seriously. Here are some easily overlooked clinical signs along with their potential significance. This is not meant to be an inclusive list, so be sure to ask your veterinarian about any unusual signs in your cat.
- Eating less/not eating: Cats need to eat regular meals. Cats that stop eating, especially if they’re fat, can develop liver disease. If you haven’t been able to get your cat to eat for 24 hours, talk to your veterinarian. Decreased appetite in cats may be a sign of gastrointestinal disease, but may also be a sign of generalized disease and poor health.
- Eating more: If your cat suddenly develops a voracious appetite, he may have an endocrine disease such as diabetes or hyperthyroidism. You should be especially concerned if your cat eats more but does not gain, or even loses, weight.
- Increased urination: Although you might not directly observe your cat using the litterbox more frequently, chances are you will notice increased litter clumping or odor in the box. You may find yourself changing the litter more frequently. This can be a sign of diabetes, kidney disease, hyperthyroidism, or other problem.
- Decreased urination: Especially with a male cat, decreased urination could be a sign of developing urinary blockage. If your cat stops urinating, this is a medical emergency. Your cat may exhibit signs of pain or distress when attempting to urinate.
- Urination outside the litter box: Urinary pain may cause your cat to avoid the litterbox. The joint pain of arthritis may also be associated with inappropriate urination outside the box. If it’s painful to enter the box, your cat will be reluctant to use it. If your cat has consistently used the litter box but begins to have accidents in the house, consult your veterinarian.
- Increased activity level: If your laid-back and lazy cat turns into a dynamo in constant motion, you should be suspicious of an underlying problem. Hyperthyroidism is common in cats and can cause increased activity.
- Decreased activity level: A noticeable decrease in your cat’s activity may also be a sign that your cat needs a check-up. Arthritis can lead to decreased activity as can systemic disease.
- Change in vocalization: If you notice that your cat is calling out more, or less, or has a change in her voice, it’s time for a check-up. Changes in the frequency and intensity of vocalization may be a sign of pain or underlying disease. Changes in tone can be due to respiratory problems, polyps, hyperthryoidism, or other illness.
- Ear scratching or head shaking may be a sign of infection or ear mites.
- Changes in coat quality: If your cat is not grooming herself, it may be because of pain or illness. Arthritis may make grooming more difficult for cats. Disease can sap energy and lead to decreased grooming. Any time you notice a change in your cat’s coat, you should suspect a problem.
- Weight loss or loss of muscle: If you cat is getting thinner or if you notice that the muscles feel smaller, this may be a sign of a number of systemic diseases including diabetes, hyperthyroidism, renal disease, gastrointestinal disease, and others. These signs may develop so gradually that you may not notice the change over time.
A case study
My favorite cat, Boogey, was not doing well. His parents hadn’t noticed anything specific, but he wasn’t as energetic as usual and just looked a little scruffy to them. He was free fed, but his owners didn’t note an increase or decrease in the amount he was eating. He may or may not have been using his litterbox more.
Although his signs were mild and non-specific, his parents decided to have him checked out. Sure enough, bloodwork showed that he had developed diabetes. Once he was treated with insulin, his parents observed marked improvement in his coat condition, but also in his body condition. They hadn’t noticed that he was gradually losing muscle tone. Even though his diet was restricted, he was able to put on weight once his disease was treated.
Boogey’s story demonstrates that a cat can be seriously ill but show only mild signs. He had a good outcome, but if his parents hadn’t taken him in to see the veterinarian, the story might have ended in tragedy. Subtle signs of illness in cats require prompt medical attention.
1 Merola, I. and Mills, D., Behavioural Signs of Pain in Cats, an Expert Consensus, PLoS One, 2016, 11(2).
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